OBJECTIVE: Human papillomavirus (HPV) causes adult-onset recurrent respiratory papillomatosis (AORRP), but AORPP prevalence is much lower than HPV prevalence. Thus, HPV infection is necessary, but not sufficient, to cause AORRP and other factors likely contribute to its pathogenesis. The present study aimed to investigate whether co-infection with herpetic viruses may contribute to the pathogenesis of AORRP. DESIGN: Prospective case-control study conducted from January 2018 to November 2019. SETTINGS: Tertiary referral centre. PARTICIPANTS: Eighteen consecutive patients with AORRP and 18 adults with healthy laryngeal mucosa (control group) undergoing surgery. MAIN OUTCOME MEASURES: Cytomegalovirus, Epstein-Barr virus (EBV), herpes simplex viruses 1 and 2, human herpesvirus 6, varicella zoster virus and HPV (including genotyping) were detected in biopsies of papilloma or healthy mucosa using real-time polymerase chain reaction and reverse line blot. Dysplasia and Ki67 levels were determined in papilloma specimens. RESULTS: EBV was present in 6 (33.3%) AORRP patients and no control patients (P = .019). Presence was not dependent on tobacco exposure (P = .413) or HPV genotype or concentration (P > .999). EBV presence was strongly related to increased cell proliferation (P = .005) and number of previous surgeries (P = .039), but not dysplasia (P > .999). Human herpesvirus 6 was found in 3 (16.7%) AORRP biopsies, with one false positive. No other herpetic virus was found. CONCLUSIONS: Unlike other herpetic viruses, EBV seems to interact with HPV, enhancing cell proliferation and contributing to the pathogenesis and progression of AORRP. Further research is required to elucidate specific interactions and their role in the pathogenesis of AORRP.
- MeSH
- biopsie MeSH
- infekce dýchací soustavy virologie MeSH
- infekce papilomavirem virologie MeSH
- laryngoskopie MeSH
- lidé středního věku MeSH
- lidé MeSH
- prospektivní studie MeSH
- recidiva MeSH
- rizikové faktory MeSH
- senzitivita a specificita MeSH
- studie případů a kontrol MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: To evaluate 5-year voice outcomes of vocal fold augmentation (VFA) using autologous fat (AF) injection via direct microlaryngoscopy versus office-based calcium hydroxylapatite (CaHA) injection. METHODS: Retrospective study of patients who underwent VFA between 2012 and 2015, with a 5-year follow-up. Patients with a glottic gap of ≤ 3 mm caused by unilateral vocal fold paralysis or vocal fold atrophy were included in the study. VFA was performed using AF injection via direct microlaryngoscopy in 17 patients, and using office-based CaHA injection in 19 patients. Subjective satisfaction with voice, voice handicap index (VHI), and maximal phonation time (MPT) were analyzed pre-injection, and at 12 and 60 months post-VFA. RESULTS: Altogether 36 patients underwent VFA between 2012 and 2015, of whom 5 were excluded within 1 year post-VFA, and 2 were excluded between 1 and 5 years post-VFA. Of the remaining 29 patients, 3 (10.3%) underwent re-intervention at between 1 and 3 years post-VFA. Thus, the 5-year follow-up included 26 patients (72.2%; 11 males and 15 females). At 5 years after surgery, 73.1% of the patients were satisfied with their voice, with no significant between-group difference (P = 0.307). The mean improvement of VHI was 28.8 ± 17.82 in the autologous fat group versus 33 ± 26.24 in the CaHA group (P = 0.458). MPT improvement was also similar between the two groups: 6.2 ± 4.26 for the autologous fat group versus 6.3 ± 4.34 for the CaHA group (P = 0.667). CONCLUSIONS: Both AF injection via direct microlaryngoscopy and office-based CaHA injection yielded good and comparable 5-year results.
- MeSH
- hlasové řasy * chirurgie MeSH
- hydroxyapatit * MeSH
- lidé MeSH
- retrospektivní studie MeSH
- vápník MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
<b>Aim:</b> The aim of this study was to compare the odontogenic and tonsillar origins of deep neck infection (DNI) as a negative prognostic factor for developing complications. </br></br> <b>Methods:</b> This was a retrospective study of 544 patients with tonsillar and odontogenic origins of DNI treated between 2006 and 2015 at 6 ENT Departments and Departments of Oral and Maxillofacial Surgery. Complications from DNI (descending mediastinitis, sepsis, thrombosis of the internal jugular vein, pneumonia, and pleuritis) were evaluated in both groups and compared. Associated comorbidities (cardiovascular involvement, hepatopathy, diabetes mellitus respiratory involvement, gastroduodenal involvement) were reviewed. </br></br> <b>Results:</b> Five hundred and forty-four patients were analyzed; 350/544 males (64.3%) and 19/544 females (35.7%). There were 505/544 cases (92.8%) with an odontogenic origin and 39/544 cases (7.2%) with a tonsillar origin of DNI. Complications occurred more frequently in the group with tonsillar origin of DNI (P < 0.001). There was no difference in diabetes mellitus between the two groups. </br></br> <b>Conclusions:</b> Currently, the tonsillar origin of DNI occurs much less frequently; nevertheless, it carries a much higher risk of developing complications than cases with an odontogenic origin. We recommend that these potentially high-risk patients with a tonsillar origin of deep neck infections should be more closely monitored.
- MeSH
- krční mandle MeSH
- krk * chirurgie MeSH
- lidé MeSH
- mediastinitida * etiologie MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: Balloon Eustachian tuboplasty (BET) appears to be a promising therapeutic option for Eustachian tube dysfunction. However, data are lacking on its effect in adults with chronic otitis media with effusion (COME) and whether it should be combined with tympanocentesis. The aim of our study was to determine if there is a beneficial effect of BET combined with tympanocentesis compared with BET only and provide data on the effect of BET in adults with COME. STUDY DESIGN: Randomized clinical trial. SETTING: Tertiary referral hospital. PARTICIPANTS: Adults with COME lasting more than 6 months after tympanostomy tube exclusion. Among 40 eligible ears, 30 were randomized to treatment. INTERVENTION: BET (group 1) versus BET with concurrent tympanocentesis (group 2). MAIN OUTCOME MEASURES: Tympanometry, Valsalva or Toynbee maneuver with tympanometry verification, Eustachian Tube Dysfunction Questionnaire, and pure-tone audiometry. RESULTS: A total of 25 patients (14 ears in group 1 and 15 ears in group 2) were included in the analysis. No significant difference in the effect of treatment was found between the groups. When patients were evaluated as one group, after 2, 6, and 12 months, improvement was found in tympanometry in 55, 48, and 48%; in the ability to perform maneuvers in 55, 41, and 41%; in audiometry in 69, 62, and 59%; and in questionnaire scores in 76, 72, and 69%, respectively. CONCLUSIONS: There was no beneficial outcome of tympanocentesis performed concurrently with BET and therefore it should not be routinely recommended. The success of therapy appears to be reduced compared with other pathologies caused by Eustachian tube dysfunction.
- MeSH
- dospělí MeSH
- Eustachova trubice * chirurgie MeSH
- lidé MeSH
- otitis media s výpotkem * chirurgie MeSH
- retrospektivní studie MeSH
- tympanocentéza MeSH
- ventilace středního ucha MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
- Research Support, N.I.H., Extramural MeSH
PURPOSE: Electrical stimulation-supported therapy is an often used modality. However, it still belongs to experimental methods in the human larynx. Data are lacking with which to evaluate the real effect in recurrent laryngeal nerve injury. The aim of this study was to investigate whether transcutaneous electrical stimulation added to voice therapy has a beneficial effect compared to voice therapy alone on vocal fold movement recovery in the case of an injured macroscopically intact recurrent laryngeal nerve. METHODS: Adults with unilateral vocal fold paralysis after thyroidectomy, in which the recurrent laryngeal nerve was left macroscopically intact, were included in this case-control study performed in tertiary referral hospital between September 2006 and June 2018. Among 175 eligible participants, 158 were included. Compliance with 6 months follow-up was 94.3%. INTERVENTIONS: medicament therapy and voice therapy (group 1) vs. medicament therapy and voice therapy and transcutaneous electrical stimulation (group 2). MAIN OUTCOME: vocal fold movement. RESULTS: A total of 149 patients were included in the analysis (group 1, 89 patients; group 2, 60 patients). The groups were homogenous. In groups 1 and 2, 64% and 60% of vocal folds, respectively, were improved after 6 months (P = 0.617). No difference was found between patients who improved and patients who did not improve. CONCLUSIONS: Adding transcutaneous electrical stimulation to voice therapy provided no beneficial effect on the recovery of vocal fold movement. Therefore, its indications should be re-evaluated; it is questionable whether stimulation should be routinely recommended.
Úvod: Fyziologický sluch je zásadní pro rozvoj komunikace a mentální vývoj. Cílem screeningu sluchu novorozenců je včasná detekce a rehabilitace sluchové vady. Plošný screening je prováděn v řadě zemí, Česká republika k nim, bohužel, reálně nepatří. Prvním krajem, ve kterém se podařilo vybudovat systém celoplošného screeningu sluchu novorozenců na regionální úrovni, byl Moravskoslezský kraj v roce 2010. Pravidelně jsou sledovány a uveřejňovány jeho výsledky. Naposledy byly veřejně referovány výsledky roku 2016. Metody: Retrospektivní zhodnocení výsledků screeningu sluchu dětí narozených v Moravskoslezském kraji v roce 2017 a 2018. Výsledky: V roce 2017 bylo živě narozeno 11 646 dětí, celkem vyšetřeno 11 520 (98,92 %) dětí. Na re-screening bylo odesláno 426 (3,7 %) dětí, šest na něj nepřišlo - compliance 98,83 %. Do regionálního screeningového centra bylo odesláno 325 dětí, 280 dětí na vyšetření dorazilo - compliance 86,15 %. Trvalá porucha sluchu byla zjištěna u 10 dětí (0,09 %). Devíti dětem byl sluch kompenzován sluchadlem, jedno dítě bylo zařazeno do programu kochleárních implantací. Dalších devět dětí bylo ponecháno ve sledování. V roce 2018 bylo živě narozeno 11 920 dětí, celkem bylo vyšetřeno 11 872 (99,6 %) dětí. Na re-screening bylo odesláno 427 (3,6 %) dětí, 35 na něj nepřišlo - compliance 91,8 %. Do regionálního screeningového centra bylo odesláno 317 dětí, 299 dětí na vyšetření dorazilo - compliance 94,32 %. Trvalá porucha sluchu byla zjištěna u 13 dětí (0,11 %). Deseti dětem byl sluch kompenzován sluchadlem, tři děti byly zařazeny do programu kochleárních implantací. Závěr: Screening sluchu v Moravskoslezském kraji je dlouhodobě zaveden a má nezastupitelný význam. Přesto je i zde stále prostor ke zlepšení a ani zde nejsou vyšetřeni všichni novorozenci. Důvodem je zvláště nízká compliance rodičů s doporučenými vyšetřeními.
Background: Hearing is essential to the normal speech and language development. The purpose of newborn hearing screening is the early detection and rehabilitation of hearing loss. Universal newborn hearing screening is well established in many countries over the world. Unfortunately, the Czech Republic does not belong to them. Moravian-Silesian Region was the very first area, in which universal newborn hearing screening was established at the regional level. It was in 2010. Since then, its results have been monitored and published, last publicly reported results are from 2016. Methods: Retrospective analysis of hearing screening of all newborns born in Moravian-Silesian Region in 2017 and 2018. Results: Altogether 11646 children were born in Moravian-Silesian Region in 2017. A total of 11520 (98.92%) were examined. Six children from 426 did not come to re-screening, 325 children were referred to the regional screening center, 280 children came. Compliance was 98.83% and 86.15% respectively. Ten children (0.09%) were diagnosed with permanent hearing loss, which was compensated by hearing aids in nine children and by cochlear implantation in one child. Nine children remain in follow-up. Altogether 11920 children were born in Moravian-Silesian Region in 2018. A total of 11872 (99.6%) were examined. Thirtyfive children from 427 did not come to re-screening, 317 children were referred to the regional screening center, 299 children came. Compliance was 91.8% and 94.32 % respectively. Thirteen children (0.11%) were diagnosed with permanent hearing loss, which was compensated by hearing aids in ten children and by cochlear implantation in three children. Nine children remain in follow-up. Conclusion: The newborn hearing screening has been functioning for a long time in Moravian-Silesian Region and is still essential. However, there is still room for improvement as not all newborns were examined. This is particularly due to the low parents´ compliance.
- Klíčová slova
- screening sluchu,
- MeSH
- dítě MeSH
- lidé MeSH
- novorozenec MeSH
- novorozenecký screening * MeSH
- poruchy sluchu diagnóza epidemiologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- diagnostické techniky otologické * MeSH
- diagnostické zobrazování metody MeSH
- Eustachova trubice diagnostické zobrazování MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- Klíčová slova
- obstrukce sluchové trubice, vzdušné sprchy,
- MeSH
- Eustachova trubice patologie MeSH
- lidé MeSH
- nemoci ucha terapie MeSH
- otologické chirurgické výkony metody MeSH
- ventilace středního ucha * metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- Eustachova trubice * fyziologie MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
